544. Strain-Specific Clinical Characteristics of Human Coronavirus Infection Among Adolescents and Adults with Influenza-like Illness
Session: Poster Abstract Session: Respiratory Viruses
Thursday, October 8, 2015
Room: Poster Hall
Background: Coronavirus is a known cause of influenza-like illness (ILI). While the clinical characteristics of highly virulent (i.e. SARS and MERS-CoV) coronavirus strains have been increasingly described, a comparative symptomatology of the more common strains (229E, OC43, NL63, HKU1) has been limited. We evaluated strain-specific clinical characteristics of human coronavirus infection among otherwise healthy adolescents and adults with ILI.   Methods: The Acute Respiratory Infection Consortium (ARIC) conducted an observational, longitudinal study of ILI at five US military treatment facilities from 2009-2014. Participants were otherwise healthy military members, retirees, and their dependents. Symptom data was captured prospectively on days 0, 3, 5, and 7 by interview and patient diary. Nasopharyngeal specimens were collected for etiologic determination by multiplex assay (Diatherix Laboratories, Inc.) that included the four common coronavirus strains.   Results: Of 898 patients with ILI, 111 (12.3%) were positive for coronavirus. Of these, 29 (26.1%) were excluded because they were <13y (n=15) or had a viral co-infection (n=14). Of the 82 cases included, 28 (34.1%) were OC43, 23 (28%) were 229E, 18 (21.9%) were NL63, and 13 (15.9%) were HKU1. Fifty-one percent were female. The mean age was 28y with a range of 13-49y. Sixty percent were Caucasian, 24% African American, 5% Asian, and 11% were classified as other. The composite scores for upper respiratory, lower respiratory, systemic, gastrointestinal, and total symptoms peaked at day 3 and did not significantly differ by strains (Figures 1 & 2). One-way ANOVA analysis revealed that patients with HKU1 infection reported higher severity of gastrointestinal symptoms at day 0 (p=.05), day 1 (p=.03), and day 3 (p=.04; Figure 2).    Conclusion: Coronavirus accounted for 12.3% of cases among adolescents and adults with ILI. Strain-specific differences were observed, notably a higher severity of gastrointestinal symptoms for those with HKU1infection.
Monique Bouvier, MSN, C-PNP1,2, John Arnold, MD2, Wei-Ju Chen, PhD3, Mary Fairchok, MD4, Christina Schofield, MD FACP, FIDSA5, Kristina J. St. Clair, DO, MTM&H6, Patrick Danaher, MD, FIDSA7, Michael Rajnik, MD8, Leslie Malone, MS, MB(ASCP)CM9, Elena Grigorenko, PhD10, Donald Stalons, PhD, D(ABMM), MPH9, Deepika Mor, MS3, Michelande Ridore, MS11, Timothy Burgess, MD, MPH8 and Eugene Millar, PhD12, (1)Nursing, University of San Diego, San Diego, CA, (2)Naval Medical Center San Diego, San Diego, CA, (3)Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, MD, (4)Infectious Disease Clinical Research Program, Tacoma, WA, (5)Madigan Army Medical Center, Tacoma, WA, (6)Naval Medical Center Portsmouth, Portsmouth, VA, (7)San Antonio Military Health System, Fort Sam Houston, TX, (8)Walter Reed National Military Medical Center, Bethesda, MD, (9)Diatherix Laboratories, Inc., Huntsville, AL, (10)Diatherix Laboratories, Inc, Huntsville, AL, (11)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (12)Infectious Disease Clinical Research Program, Rockville, MD

Disclosures:

M. Bouvier, None

J. Arnold, None

W. J. Chen, None

M. Fairchok, None

C. Schofield, None

K. J. St. Clair, None

P. Danaher, None

M. Rajnik, None

L. Malone, Diatherix Lab: Investigator , Salary

E. Grigorenko, Diatherix lab: Investigator , Salary

D. Stalons, Diatherix Lab: Investigator , Salary

D. Mor, None

M. Ridore, None

T. Burgess, None

E. Millar, None

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